Provider Demographics
NPI:1215310677
Name:BRANDT, EMILY C (CRNP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:C
Last Name:BRANDT
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:C
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:31 COBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078-8742
Mailing Address - Country:US
Mailing Address - Phone:507-301-1817
Mailing Address - Fax:717-867-4981
Practice Address - Street 1:1251 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:PA
Practice Address - Zip Code:17003-1643
Practice Address - Country:US
Practice Address - Phone:717-867-4671
Practice Address - Fax:717-867-4981
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015060363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103028581Medicaid
PA424183Medicare PIN